B. Parma

Untreated celiac disease

Celiac disease (CD) is an immune-mediated lifelong enteropathy characterized by an abnormal T-cell response to gluten (a complex protein contained in wheat, rye and barley) in genetically susceptible individuals. CD is the most frequent food intolerance and it can occur at any age. During childhood, clinical manifestations of untreated CD include malabsorption (chronic diarrhea, failure to thrive and abdominal distention), but the clinical picture can also include a wide spectrum of atypical gastrointestinal and systemic symptoms. Many complications of the disease, which were originally described chiefly in adults, can nowadays be observed in children and adolescents. This review presents an overview of the clinical picture and complications of untreated CD in children.

PA21 ANTIBODIES AGAINST SYNTHETIC DEAMIDATED GLIADIN PEPTIDES FOR THE DIAGNOSIS OF CHILDHOOD CELIAC DISEASE: DO THEY PLAY A ROLE?

Objectives: Previous studies have described the high sensitivity and specificity of antibodies against synthetic deamidated gliadin peptides (AdGA) in celiac disease (CD) patients (pts). The aims of this study are to confirm the sensibility, specificity, negative and positive predictive value (NPV, PPV) of AdGA and to verify the correlation of AdGA with anti tissue transglutaminase antibodies (tTG-Ab) in pts investigated for CD. Materials and methods: IgA and IgG AdGA were tested by an enzymelinked immunoabsorbent assay (Kit Inova Diagnostic). IgA and IgG tTG-Ab were measured by radio-binding assay. The histological study was done according to the Marsh’s classification modified by Oberhuber (M/O). Patients: 102 pts (62 F, 40 M, age M±SD: 7±4 ys) were studied by upper endoscopic biopsy for gastrointestinal symptoms or for suspected CD: n=78 → CD (typical lesions) n=11 → potential CD (positive tTG-Ab and DQ2/DQ8, normal histology) n=13 → gastrointestinal control (normal histology, negative tTG-Ab) Results: (1) AdGA-IgA were positive in 52/78 of CD pts, in 2/11 of potential